Lessons in healthcare efficiency from India

Research has shown that U.S. healthcare lags behind that of other developed Western nations, but America's healthcare system could also take cues from India in its efforts to make care more efficient, argues a blog post published on NEJM Catalyst.

Like their counterparts in high-income nations, providers in middle-to-low-income nations such as India often face high patient volumes and large provider-to-patient ratios, write Mark D. Huffman, M.D., of Northwestern University Feinberg School of Medicine, and Padinhare P. Mohanan, M.D., of Kerala, India's Westford-HiTech Hospital.

To handle this imbalance, Indian doctors began limiting blood-pressure measurement to systolic blood pressure instead of measuring both systolic and diastolic blood pressure. That simple step saves physicians a half an hour each day, according to the post. While U.S. clinicians aren't likely to take this particular step, even though most doctors base care decisions on systolic blood pressure, it illustrates just how much of healthcare providers' routines involve collecting data that have no effect on treatment, Huffman and Mohanan write.

India and other densely populated regions such as sub-Saharan Africa also have the problem of clinician shortages in common with the U.S. But they increasingly use more nonphysician and community health workers, according to the commentary. Comparatively, a minority of U.S. states have laws regulating community health workers and their scope of practice, despite their demonstrable value in improving care and outcomes.

U.S. healthcare can also take inspiration from India's use of a "hub-and-spoke" healthcare model, in which major hospitals operate in the nation's large cities with smaller providers in nearby rural areas, as well as keeping costs under control through strategies such as using locally-manufactured devices and, safety permitting, reusing sterilized devices rather than discarding them after a single use, FierceHealthcare previously reported.